ECE2015 Guided Posters Adrenal (2) (8 abstracts)
Radiofrequency bipolar ablation therapy for primary aldosteronism patients: investigator-initiated exploratory clinical trial
Kei Takase 1 , Kazumasa Seiji 1 , Ryo Morimoto 2 , Yoshizugu Iwakura 2 , Yoshikiyo Ono 2 , Kei Omata 2 , Masataka Kudo 2 , Tomo Kinoshita 1 , Fumitoshi Satoh 2 & Sadayoshi Ito 2
1Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan; 2Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Hospital, Sendai, Japan.
Purpose: To evaluate safety and efficacy of percutaneous radiofrequency ablation therapy for unilateral aldosterone producing adrenal adenoma in normalising aldosterone secretion.
Patients: Eight cases of aldosterone producing adrenal adenoma with following conditions: i) CT detectable adenoma without any risky organs on a puncture route. ii) Intervening adipose tissue between target adenoma and adjacent risky organs (pancreas or intestine). iii) Unilateral single functioning macroadenoma with aldosterone hypersecretion proven by adrenal venous sampling.
Methods: CT guided puncture of adrenal adenoma with one or two (according to the size of the adenoma) bipolar radiofrequency ablation needle was performed, followed by ablation with total power of 4–6 kJ. Blood pressure was monitored with an arterial catheter during the procedure. Aldosterone levels in serum and 24-h urine collection 7 days after ablation were evaluated as primary outcomes. ACTH, cortisol, serum aldosterone, renin activity, osmotic pressure, potassium level, urine osmolality, and antihypertensive medication dose at screening, 3, 7, 28, and 84 days after ablation therapy were also evaluated. Ablation effect was morphologically evaluated by enhanced CT 7 days after treatment.
Results: In all cases, aldosterone levels in serum and 24-h urine were significantly decreased; Serum potassium level was normalized without anti-aldosterone therapy. Postoperative CT showed complete ablation in six cases and subtle residual enhanced area in two cases. Doses of anti-hypertensive medication were reduced in all cases including two drug-free patients after ablation. No severe procedure-related complication was observed.
Conclusion: Bipolar radiofrequency ablation is thought to be safety and effective in treating primary aldosteronism.
Disclosure: Project of promoting innovative medidal devices by Ministry of Health, Labour and Welfar, Japan.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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